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Background <p>Digital monitoring shows promise for detecting disease activity in people with relapsing–remitting multiple sclerosis (PwRRMS). Here, we study associations between digital biomarkers for cognition and walking ability and radiological disease activity.</p> Methods <p>In a prospective, 1-year cohort study, PwRRMS performed the smartphone-based symbol digit modalities test (sSDMT) and 2-min walk test (s2MWT) on weekly basis. MRIs and the clinical SDMT (cSDMT), expanded disability status scale (EDSS), timed 25-foot walk (T25FW) and nine-hole peg test (NHPT) were collected at baseline and every 3&#xa0;months. Associations were determined using logistic generalized estimating equations. For the digital measures, associations were also analyzed using a hybrid model and were repeated with values from 6&#xa0;weeks before and after MRI.</p> Results <p>We included 57 PwRRMS. The sSDMT was negatively associated with contrast-enhancing lesions (CELs) (OR<sub>overall</sub> 1.80, 95% CI 1.12–2.91), predominantly caused by variation within individuals (OR<sub>within-subjects</sub> 4.37, 2.05–9.33), with a similar relation using sSDMT values 6&#xa0;weeks prior to MRI (OR<sub>overall</sub>: 1.92, 0.947–3.90, OR<sub>within-subjects</sub>: 13.7, 1.74–107). The negative association between s2MWT and CELs (OR<sub>overall</sub> 1.20, 1.04–1.38) was caused equally by variation within and between individuals. All clinical measures were negatively associated with CELs: T25FW (OR<sub>overall</sub> 2.23, 1.50–3.32), EDSS (OR<sub>overall</sub> 1.49, 0.932–2.39), cSDMT (OR<sub>overall</sub> 1.20, 1.02–1.42) and NHPT (OR<sub>overall</sub> 1.15, 1.04–1.27).</p> Discussion <p>Digital biomarkers show to be capable of measuring changes in individuals when inflammation is detectable on MRI, with the sSDMT additionally capturing changes 6&#xa0;weeks prior to the MRI, suggesting that early identification of inflammation using these biomarkers may be possible.</p>

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Digital monitoring of disease activity in relapsing–remitting multiple sclerosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月6日

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  • P. C. G. Molenaar,
  • D. J. de Jong,
  • S. N. Hof,
  • P. van Oirschot,
  • I. G. Bucur,
  • K. H. Lam,
  • B. Moraal,
  • T. M. Heskes,
  • V. de Groot,
  • B. M. J. Uitdehaag,
  • B. A. de Jong,
  • J. W. R. Twisk,
  • E. M. M. Strijbis,
  • J. Killestein

摘要

Background

Digital monitoring shows promise for detecting disease activity in people with relapsing–remitting multiple sclerosis (PwRRMS). Here, we study associations between digital biomarkers for cognition and walking ability and radiological disease activity.

Methods

In a prospective, 1-year cohort study, PwRRMS performed the smartphone-based symbol digit modalities test (sSDMT) and 2-min walk test (s2MWT) on weekly basis. MRIs and the clinical SDMT (cSDMT), expanded disability status scale (EDSS), timed 25-foot walk (T25FW) and nine-hole peg test (NHPT) were collected at baseline and every 3 months. Associations were determined using logistic generalized estimating equations. For the digital measures, associations were also analyzed using a hybrid model and were repeated with values from 6 weeks before and after MRI.

Results

We included 57 PwRRMS. The sSDMT was negatively associated with contrast-enhancing lesions (CELs) (ORoverall 1.80, 95% CI 1.12–2.91), predominantly caused by variation within individuals (ORwithin-subjects 4.37, 2.05–9.33), with a similar relation using sSDMT values 6 weeks prior to MRI (ORoverall: 1.92, 0.947–3.90, ORwithin-subjects: 13.7, 1.74–107). The negative association between s2MWT and CELs (ORoverall 1.20, 1.04–1.38) was caused equally by variation within and between individuals. All clinical measures were negatively associated with CELs: T25FW (ORoverall 2.23, 1.50–3.32), EDSS (ORoverall 1.49, 0.932–2.39), cSDMT (ORoverall 1.20, 1.02–1.42) and NHPT (ORoverall 1.15, 1.04–1.27).

Discussion

Digital biomarkers show to be capable of measuring changes in individuals when inflammation is detectable on MRI, with the sSDMT additionally capturing changes 6 weeks prior to the MRI, suggesting that early identification of inflammation using these biomarkers may be possible.